Decreased passive muscle stiffness of vastus medialis is associated with poorer quadriceps strength and knee function after anterior cruciate ligament reconstruction

Xin He, Wan Yun Huang, Hio Teng Leong, Ji Hong Qiu, Chun Cheong Ma, Sai Chuen Fu, Michael Tim Yun Ong, Patrick Shu Hang Yung (Corresponding Author)

Research output: Journal article publicationJournal articleAcademic researchpeer-review

8 Citations (Scopus)

Abstract

Background: Muscle deficits of the quadriceps and hamstrings are common after anterior cruciate ligament reconstruction, and increase the risk of knee reinjury. Muscle stiffness is an important factor for dynamic joint stability. However, the changes in quadriceps and hamstring muscle stiffness and its influence after anterior cruciate ligament reconstruction remain unclear. Method: Twenty-five male subjects with anterior cruciate ligament reconstruction and twenty-one matched healthy subjects participated in this study. The passive muscle stiffness of the quadriceps and hamstrings was assessed by shear modulus using ultrasound shear wave elastography. The isokinetic muscle strengths of the quadriceps and hamstrings were tested. Knee function was evaluated by the International Knee Documentation Committee and Lysholm score. Muscle stiffness was compared between limbs via non-parametric tests. Correlation analysis was used to detect the relationship between muscle stiffness, isokinetic muscle strength and knee functional scores. Findings: The involved limb exhibited significantly decreased shear modulus in the vastus medialis compared to the dominant limbs(z = −3.585;P = 0.001;ES = 1.13) and non-dominant limbs(z = −3.551;P = 0.002;ES = 1.24) of healthy controls. The shear modulus of ST was also significantly lower in the involved limb when compared with the contralateral limbs(z = −3.996;P < 0.001;ES = 1.33), dominant limbs(z = −4.477;P < 0.001;ES = 1.65) and non-dominant limbs(z = −4.234;P = 0.001;ES = 1.43) of healthy controls. The shear modulus of the vastus medialis was associated with quadriceps peak torque at 60°/s(r = 0.470; p < 0.001) and knee functional score(r = 0.459; p = 0.021). Interpretation: The passive muscle stiffness of the vastus medialis decreased after anterior cruciate ligament reconstruction, which is associated with poorer quadriceps strength and knee function. The effect of modulation of muscle stiffness on improving knee function warrants future investigation.

Original languageEnglish
Article number105289
JournalClinical Biomechanics
Volume82
DOIs
Publication statusPublished - Feb 2021
Externally publishedYes

Keywords

  • Anterior cruciate ligament
  • Knee function
  • Muscle stiffness
  • Shear wave elastography

ASJC Scopus subject areas

  • Biophysics
  • Orthopedics and Sports Medicine

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